Review essay
Theory and methods in comparative drug and alcohol policy research: Response to a review of the literature

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Abstract

Comparative drug and alcohol policy analysis (CPA) is alive and well, and the emergence of robust alternatives to strict prohibition provides exciting research opportunities. As a multidisciplinary practice, however, CPA faces several methodological challenges. This commentary builds on a recent review of CPA by Ritter et al. (2016) to argue that the practice is hampered by a hazy definition of policy that leads to confusion in the specification and measurement of the phenomena being studied. This problem is aided and abetted by the all-too-common omission of theory from the conceptualization and presentation of research. Drawing on experience from the field of public health law research, this commentary suggests a distinction between empirical and non-empirical CPA, a simple taxonomic model of CPA policy-making, mapping, implementation and evaluation studies, a narrower definition of and rationale for “policy” research, a clear standard for measuring policy, and an expedient approach (and renewed commitment) to using theory explicitly in a multi-disciplinary practice. Strengthening CPA is crucial for the practice to have the impact on policy that good research can.

Introduction

Policy is a device for scaling a practice within a legal or institutional framework. At the core of policy research is the question of what effects a practice codified in a policy produces. If the policy has positive effects, at reasonable cost and without significant side effects, research can spur the policy’s refinement and wider adoption. If a policy causes harm, or provides too few benefits to justify the costs of enforcement, research can help speed its modification or repeal. Comparative research has been used to assess the impact of policies on health (Burris & Anderson, 2013). Alcohol research, particularly in the road safety domain, has demonstrated the potential for rigour and impact in this tradition. In a 2016 review of 62 comparative policy analysis studies published since 2010, Ritter et al. report that the practice lacks “a clear definition of what counts as CPA” and consensus on methods of “policy specification” (Ritter, Livingston, Chalmers, Berends, & Reuter, 2016) (“Ritter et al.”). In an unpublished portion of the study, which I read as a peer reviewer and allude to with permission, the authors also noted the absence of explicit theory in nearly half the papers reviewed.

There is good reason to be talking now about the state of CPA. Though prohibitionist policies remain widespread, there are also many signs of declining faith in that model, leading to more openness to policy innovation and research that tests the current approach or evaluates innovations. This includes not just outright legalization of some drugs, and substantial abandonment of criminalization for others, but also policies of non-enforcement and the creation of safe spaces for services and treatment (Csete et al., 2016). There has always been “considerable room for manoeuvre” in the international conventions (Bewley-Taylor & Jelsma, 2011), and that space grows as support for prohibition declines.

As the policy environment features more legalization, or at least changes in policy and practice that make drugs a little less illegal, drug research gradually looks more like alcohol research, with greater interjurisdictional variation, better access to data and more opportunities for research funding. Chatwin (2016) suggests that this is a time of opportunity to promote policy innovation as a virtue and evaluation of innovation as a primary role of national and international drug control and health agencies. From the epistemologically Machiavellian point of view, even jurisdictions that adhere to rigid prohibition can assist in the identification of positive innovation by serving as die-hard counterfactuals.

Yet there are those bumps in the road of CPA highlighted by Ritter et al.: lack of a clear definition and taxonomy of CPA, problems in the specification of the policy under study, and a failure to exploit theory as a way to strengthen research and its utility across disciplines. I confronted these same obstacles in my work providing funding and technical assistance in the overlapping field of public health law research (PHLR)—“the scientific study of the relation of law and legal practices to population health” (Burris et al., 2010, Wagenaar and Burris, 2013). This paper draws on the PHLR experience to suggest ways to address these key challenges in CPA.

Section snippets

The importance of defining and classifying CPA

Ritter et al. (2016, p. 40) start with a crucial observation: “Comparative policy analysis is a diverse set of activities, undertaken by many different disciplines, all with their own approaches — it is not a unified field of study”. It is a good thing that contributors to CPA do not use the same theoretical frameworks, methods or designs. It is good that they may be interested in different aspects of policy phenomena, different dimensions of implementation processes, or different outcomes.

A new definition of CPA based on a model of its subject

I suggest that empirical papers in CPA fall for the most part into four groups: (1) policymaking studies, which investigate the determinants of policy and the policy-making process; (2) mapping studies, which measure policy prevalence, characteristics and/or change over time; (3) implementation studies, which investigate the process of putting a policy into practice and its proximate outcomes; and (4) evaluation studies, which try to assess the impact of policies on the world. This taxonomy

The “policy” problem — defining the independent variable

As the reader may well have noticed, the model in Fig. 1 supposes that “policy” does not include “settled practices” or “routine functions” or any other phenomenon in an organization that cannot be tied to a rule or other rule-like, formal statement of the actions required or systematically encouraged. We got here on an argument from simplicity, but there are several more important reasons to insist that CPA confine its primary gaze to formalized policies.

Such a restriction does not change much

The problem of missing theory

In an unpublished portion of Ritter et al., the authors examined the CPA literature’s deployment of theory for the conceptualization of the relationship between the policy under study and its impacts. In a preliminary analysis, the authors found that almost half of the papers in their sample did not specify any theory, and many of the remaining articles used an economic theory, often in a cursory way. Although these findings did not make it into the final paper, the problem has been noted as

Conclusion

How drug policies are made, their characteristics and distribution, how they are implemented and what impact they have are crucial social questions that raise profound questions of social justice and welfare. Building on a thorough review of recent CPA studies, I have proposed the adoption of a few basic definitions and standards for the practice. CPA is pragmatically defined as the empirical study of the development, characteristics, implementation or effects of a drug policy across more than

Acknowledgements

Work on this paper was supported in part by the National Institute on Drug Abuse (Contract Number HHSN271201500081C). The author thanks Sarah B. Klieger, MPH, for advice and assistance. The opinions expressed in the paper are solely those of the author.
Conflict of interest

The author declares that he has no conflict of interest.

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